Revive Health Concierge

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

REVIVE HEALTH CONCIERGE

Practice address

2800 E Madison St Ste 201
Seattle, WA 98112-4865

Phone

(206) 717-5622

Fax

(949) 561-4815

NPI assigned

Aug 12, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leslie Casias, ARNP

Title

Owner/Provider

Phone

(206) 717-5622

Specialties & licenses 1

Addresses

Other names 1

• Botox in the Park Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1750019147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E MADISON ST STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124865",
            "telephone_number": "206-717-5622",
            "fax_number": "855-631-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E MADISON ST STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124865",
            "telephone_number": "206-717-5622",
            "fax_number": "949-561-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTH CONCIERGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "CASIAS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "206-717-5622",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botox in the Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Botox in the Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reverve LLC
• Daniel Revette, LMT
• Ronelle Revilla
• Gabija Revis, DMD
• Revive Behavioral Health
• Revive Low T, LLC
• Revive Movement LLC
• Revive Smiles Dentistry, LLC
• Revive Therapeutics
• Revolution Wellness and Therapy

• Multi-Specialty Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Multi-Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.